RESUMO
Guidelines recommend the use of cardiac telemetry when phenytoin is administered intravenously. Clinical areas where telemetry is available may not always be the most suitable place to monitor and treat these sick patients. We sought to clarify the evidence regarding the need for cardiac telemetry during intravenous infusion of phenytoin.
Assuntos
Antiarrítmicos/administração & dosagem , Anticonvulsivantes/administração & dosagem , Arritmias Cardíacas/induzido quimicamente , Parada Cardíaca/induzido quimicamente , Testes de Função Cardíaca/normas , Monitorização Fisiológica/normas , Fenitoína/administração & dosagem , Guias de Prática Clínica como Assunto , Telemetria/normas , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Antiarrítmicos/efeitos adversos , Anticonvulsivantes/efeitos adversos , Arritmias Cardíacas/diagnóstico , Austrália , Bradicardia/induzido quimicamente , Bradicardia/diagnóstico , Hipersensibilidade a Drogas/mortalidade , Feminino , Parada Cardíaca/mortalidade , Parada Cardíaca/prevenção & controle , Testes de Função Cardíaca/estatística & dados numéricos , Humanos , Recém-Nascido , Infusões Intravenosas , Masculino , Pessoa de Meia-Idade , Monitorização Fisiológica/estatística & dados numéricos , Fenitoína/efeitos adversos , Telemetria/estatística & dados numéricos , Procedimentos Desnecessários , Adulto JovemRESUMO
Amiodarone is used to treat life-threatening cardiac arrhythmias. Amiodarone-induced pulmonary toxicity (APT) can be difficult to diagnose. APT may result in increased mucus production and mucin expression. Thus, serum mucin-1 was evaluated as a marker for amiodarone-induced pulmonary toxicity. Concentrations of mucin-1 in peripheral blood were determined using cancer-associated serum antigen (CASA) assay in patients taking amiodarone. Eight of ten patients who developed major amiodarone toxicity had high serum CASA levels. Patients with toxicity had a significantly higher mean rank CASA concentration compared with those without major toxicity. CASA shows potential as a marker for amiodarone-induced toxicity, particularly pulmonary toxicity.
Assuntos
Amiodarona/efeitos adversos , Antiarrítmicos/efeitos adversos , Pneumopatias/diagnóstico , Pulmão/efeitos dos fármacos , Mucina-1/sangue , Amiodarona/sangue , Antiarrítmicos/sangue , Testes de Função Cardíaca , Humanos , Troca Gasosa PulmonarAssuntos
Fármacos Cardiovasculares/farmacocinética , Composição de Medicamentos , Perexilina/farmacocinética , Idoso , Angina Pectoris/sangue , Angina Pectoris/tratamento farmacológico , Disponibilidade Biológica , Fármacos Cardiovasculares/administração & dosagem , Fármacos Cardiovasculares/sangue , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Perexilina/administração & dosagem , Perexilina/sangue , Equivalência TerapêuticaRESUMO
Streptokinase is the thrombolytic agent most commonly used for the treatment of acute myocardial infarction. We report eight patients who developed late uncommon adverse reactions to streptokinase probably due to immune complex disease. The clinical manifestations included vasculitic rashes, abnormal renal and liver function tests and a syndrome resembling adult respiratory distress syndrome. Major adverse events with streptokinase such as stroke, bleeding and other allergic reactions, have been previously documented but the morbidity related to delayed reactions has not been widely recognised. These reactions produced significant morbidity resulting in prolonged hospital stay and may need to be considered in the decision to use streptokinase.
